D5840.PDF

Rev. sci. tech. Off. int. Epiz., 2008, 27 (3), 751-758
A foot and mouth disease simulation exercise
involving the five Nordic countries
J.M. Westergaard (1), C.B. Andersen (2) & S. Mortensen (2)
(1) ADC-Consult, Mikkelborg Alle 7, DK 2970 Hørsholm, Denmark
(2) Danish Veterinary and Food Administration, Mørkhøj Bygade 19, DK 2860 Søborg, Denmark
Submitted for publication: 10 October 2006
Accepted for publication: 20 May 2008
Summary
Simulation exercises are considered a very valuable tool for testing contingency
plans established for the control and eradication of rapid spreading animal
diseases such as foot and mouth disease, classical swine fever and avian
influenza. An inter-Nordic simulation exercise was conducted in 2005 with the
objective of testing the national foot and mouth disease contingency plans
adopted respectively by Denmark, Finland, Iceland, Norway and Sweden. The
Central Veterinary Administrations of the five countries jointly prepared a
scenario which involved about 40 livestock holdings, 4 reindeer flocks, 6
slaughterhouses and approximately 500 people. An Excel spreadsheet with
information on the events to take place and the timetable to follow during the
exercise was a valuable tool for ensuring that the exercise was kept on track.
The evaluation of the exercise dealt both with inter-Nordic activities and the
activities of individual countries.
Keywords
Animal health – Cross-border collaboration – Foot and mouth disease – Inter-Nordic
activities – Simulation exercise.
Introduction
Foot and mouth disease (FMD) has been absent from the
Nordic countries for a number of years (Iceland: never
recorded; Norway: 1952; Finland: 1959; Sweden: 1966
and Denmark: 1983). The great economic losses caused by
FMD outbreaks in 2001 in Europe, the constant threat to
food-producing animals in FMD-free countries and the
potential for rapid spread of disease between countries
having close links in the agricultural sector, encouraged the
Nordic Council (the forum for parliamentary cooperation
between Nordic countries) to give financial support for an
inter-Nordic FMD simulation exercise in 2005. The
decision to carry out such an exercise was further
stimulated by the European Union (EU) FMD Directive
(3), which foresees that countries shall test National FMD
contingency plans by simulation exercises.
Preparation of the scenario
A simulation exercise working group with representatives
of the National Veterinary Administrations of the five
Nordic countries was established in 2004. The initial
meeting of the group dealt in particular with:
a) the aim of the exercise
b) the formulation of objectives relating to:
– inter-Nordic activities
– activities of individual countries in the light of the
prevailing animal production systems and training
requirements
c) the timetable for the preparation and conduct of the
exercise.

It was agreed at the meeting that the aim of the exercise
was: ‘to test the Contingency Plan established by each
country for the control of foot and mouth disease’ and that
the timing of the exercise should only be known in
advance to the Chief Veterinary Officers (CVO) of each
country and the members of the working group. During
the implementation of the exercise most of the Members of
the working group were acting as ‘game masters’, i.e.
persons designated to ensure that the exercise was running
on schedule.
The working group met for preparatory work on five
occasions between October 2004 and September 2005;
each country was represented by two to three veterinarians
who all were engaged in contingency planning at the
national level. A consultant assisting the working group
was responsible for preparing the agenda for meetings and
for preparing working documents and meeting reports.
It was noted by the group that although simulation
exercises are widely recommended for improving the
preparedness for the occurrence of rapid spreading animal
diseases (the former List A diseases of the World
Organisation for Animal Health [OIE]), a definition of a
simulation exercise has not been agreed at International
level. For the purpose of the inter-Nordic simulation
exercise it was agreed that a simulation exercise should
mean: ‘an organised and controlled scenario-driven event
carried out with the aim of:
– training personnel designated to be involved in an
emergency situation related to the control of potentially
rapid spreading animal diseases
– testing, reviewing and up-dating contingency plans,
disease eradication strategies and capabilities at local,
regional and/or national level’.
The definition adopted took into account experiences
gained from simulation exercises conducted in the spring
of 2004 in Denmark and in Iceland (7) and it was agreed
that the exercise should include field conditions (i.e. farms,
slaughterhouses) and that participants should work in
their normal working facilities and environment.
The scenario was based on a simulated spread of FMD
virus between the Nordic countries as shown in Figure 1.
The individual countries then developed additional
detailed national scenarios within the framework of the
inter-Nordic scenario.
The scenario included elements that required cross-border
collaboration between individual countries within different
areas relevant for disease eradication, including:
– information exchange at the level of the CVO
– epidemiological investigations
– use of an FMD model for airborne spread
– transport of diagnostic samples
– development of a policy for the transport of non-
susceptible animals such as horses and hunting dogs
– recruitment of foreign veterinarians
– administration of cross-border surveillance zones
– administration and surveillance of reindeer populations
migrating between countries.
The background documentation for the exercise was
generated in an Excel spreadsheet. The spreadsheet was
found to be an excellent tool for the preparation of a
scenario and for the game masters to coordinate the
proposed activities in the five countries whilst the exercise
was being conducted. The spreadsheet contained
Rev. sci. tech. Off. int. Epiz., 27 (3)
752
Fig. 1
Scenario of the inter-Nordic transmission of foot and mouth
disease virus
A Norwegian sheep farmer organised a workshop on specialised
production of cheese, wool and meat on his farm. Many other farmers
from the Nordic countries participated in the workshop and returned
home to their own farms with cheese products or fresh meat. At the
time of the workshop, the animals on the farm were incubating foot
and mouth disease, because five sheep of a special genetic breed with
a high milk production had been illegally imported from a country with
endemic FMD
Denmark, Finland, Iceland,
Norway and Sweden
Population:
0 to 50,000
50,000 to 500,000
500,000 to 1,000,000
1,000,000 and over
Capital
km

12 columns for placing information relating to: date, hour,
country/countries involved, event, initiator of activity,
responder, anticipated response, the element tested, name
of the file containing details about the event and the author
responsible for the text in a given row. At the time of the
start of the simulation exercise information had been
entered into 48 rows. Only the game masters were allowed
to enter data into the spreadsheet. A part of the spreadsheet
is shown in Figure 2.
Information on the conduct of the simulation exercise was
submitted to the OIE for further distribution to OIE
Member States (7).
Implementation
The simulation exercise was carried out from 19 to
23 September 2005 and it was possible for the game
master team in each country to adhere to the established
timetable given in the Excel spreadsheet (Fig. 2). A liaison
officer was appointed in each team to coordinate the
activities performed in the different countries.
The scheduled cross-border collaboration between the
Nordic countries took place at both the level of the CVO
and on the sub-CVO level by use of phone calls, faxes,
emails and telephone conferences. In addition to the inter-
Nordic activities, the individual countries had the
opportunity to carry out activities which paid particular
attention to issues of national interest. Information on the
use of livestock holdings and persons involved in the
exercise is given in Table I, which also contains
information on issues tested by different countries.
The tasks performed in the field when FMD was suspected
involved the owners of farms, private veterinarians and the
official veterinarian. The measures applied or simulated
were those outlined in Section 2: ‘Measures in case of
Rev. sci. tech. Off. int. Epiz., 27 (3) 753
Fig. 2
Inter-Nordic foot and mouth disease simulation exercise 2005: a spreadsheet was developed to describe the scenario and the timing
of the introduction of each new element during the simulation exercise
Each row represents a significant event. Columns A and B specify the date and hour at which an activity should to be initiated, column C specifies in
which country, column D provides information on the event, columns E and F describe who will initiate the event and who should respond. Columns G
and H describe which section of the contingency plan is being tested and column I links to the documents handed out to the participants in the
exercise, e.g. a made-up laboratory test result

national FMD reference laboratory in Denmark.
The samples from Iceland were initially refused by the
airline due to the labelling of the parcel, in spite of the fact
that the Central Veterinary Administration of Iceland had
obtained assistance from a recognised transport company,
which operates worldwide. In general, the involvement of
the laboratories was limited to receiving samples from the
field, as outlined in the scenario, and no attempt was made
in this exercise to determine the capacities of the national
reference laboratories.
In-depth epidemiological investigation is of paramount
importance for controlling FMD, so epidemiological
investigations were carried out at all farms when disease
was suspected. The investigations took the form of a
questionnaire, the lay-out of which varied slightly from
country to country; but all questionnaires dealt with:
– potential source of infection
– duration of infection in the herd
– the movement of animals, persons, vehicles and
substances (milk, meat, wool, slurry, manure, animal feed,
etc.) likely to have carried the FMD virus to or from the
herd in question.
Rev. sci. tech. Off. int. Epiz., 27 (3)
754
suspicion of an outbreak of foot-and-mouth disease’ in
Council Directive 2003/85/EC (3). The owners of herds in
which disease was suspected, and the private veterinarians
who would normally provide veterinary assistance to the
herds, had been contacted two to three months prior to the
exercise to ensure their:
– willingness to participate in the simulation exercise
– promise of secrecy with regard to date of disease
suspicion
– agreement on remuneration.
On the day of the visit by the practicing veterinarian, the
owner of an FMD suspected herd handed over to the
veterinarian a letter which contained information on the
signs of FMD and photos of lesions. The information
received in the letter was used by the practicing
veterinarian at the moment a call was made to the official
veterinarian concerning the suspicion.
The specimens (blood and/or milk) collected at the time of
suspicion were submitted to the national FMD reference
laboratories for examination and the outcome of
the examinations (time of reply and result) was given in the
scenario. Two countries, Finland and Iceland, took
the opportunity to test transport of samples by air to the
Table I
Inter-Nordic foot and mouth disease simulation exercise 2005: information on the scope of the exercise with regard to livestock
holdings and persons involved and issues given special attention by individual countries
Number of livestock
Countries holdings and industries Persons involved Issues given special attention at national level
involved
Denmark Pigs (14) >200 – disease suspicion and confirmation
Sheep and goats (5) – stamping out
Cattle (3) – cooperation between Central Veterinary Administration and external
Livestock markets (1) institutions and organisations
Slaughterhouses (3) – trade issues
– air-borne spread
– emergency vaccination
Finland Cattle (8) >80 – operation of national disease control and local disease control centres
Pigs (2) – disease suspicion and confirmation
Reindeer flocks (3) – milk collection
Slaughterhouses (1) – contact with the media
Iceland Sheep (1) >15 – operation of national disease control centre
Slaughterhouses (1) – disease suspicion
– transport of infectious material by air
– review of legislation and contingency plan
Norway Sheep (1) >150 – operation of national disease control and local disease control centres
Cattle (1) – disease suspicion
Pigs (1) – disease confirmation
Reindeer flocks (1) – contact with the media
Slaughterhouses (1)
Sweden Cattle (2) >50 – operation of national disease control centre
Pigs (1) – disease suspicion
Slaughterhouses (1) – disease confirmation

When the disease was confirmed in Denmark work was
initiated concerning the determination of the potential
airborne spread of the FMD virus. Data collected at the
infected farm (estimated virus release) and meteorological
data obtained from the Danish Meteorological Institute
were used in established FMD virus airborne spread
models. The results obtained from the models (an
atmospheric long-range dispersion model and an
atmospheric short-range dispersion model) were
communicated to the CVOs and game masters in Finland,
Norway and Sweden.
It is important to ensure that documents produced and
circulated during a simulation exercise are not mixed up
with normal documents. In order to prevent this problem
a printed watermark with the written text ‘EXERCISE’ was
inserted in all exercise documents. In connection with
telephone conversations the caller would start the
conversation with the words ‘This is an exercise’ to avoid
misunderstandings. In two countries the central veterinary
administrations established a special ‘simulation exercise
mail-box’ by using a log system that is part of the Microsoft
Outlook programme.
None of the five countries carried out culling of animals;
but cleaning and disinfection facilities were established for
persons entering and leaving farms. Furthermore, killing
teams were called to some of the farms where outbreaks
were confirmed.
Two countries – Denmark and Finland – prepared a plan
for emergency vaccination against FMD during the
exercise. The plan took into account the criteria listed in
Council Directive 2001/85/EC (3), which include:
– population density of susceptible animals
– predominant species clinically affected
– movement of potentially infected animals and products
out of the established protection zone(s)
– predicted airborne spread of virus from infected
holdings
– suitable vaccine
– origin of the outbreak with regard to traceability
– distribution of outbreaks
– public reaction to stamping out
– economic assessment of competing control strategies.
Furthermore, the logistic aspects of vaccination were
simulated by desk top exercises.
Evaluation of
simulation exercise
The evaluation of the FMD simulation exercise looked at
both inter-Nordic events and national events. The main
topics included in the evaluation process were:
– management, particularly decision making and policy
development
– technical aspects covering disease surveillance,
diagnostic capabilities and capacities, use of FMD airborne
spread models, culling and disposal of animals
– communication between countries and media
communication
– information transfer with regard to epidemiological data
and use of Geographical Information Systems (GIS)
– resources in relation to personnel and equipment
– lessons learnt during the exercise, i.e. what went well
and what went wrong.
An external evaluator carried out the evaluation of the
inter-Nordic events. An evaluation questionnaire
containing 82 questions covering the main topics listed
above was developed and used by all countries during the
evaluation process. Furthermore, the individual countries
evaluated the national events by use of ‘wash-up meetings’
with stakeholders and observers who had participated in
the exercise and also by use of specially designed
questionnaires.
The outcome of the evaluation was that the FMD
simulation exercise from 19 to 23 September 2005 was
considered to have been a very valuable exercise. Feedback
from participants indicated that the objectives of the
exercise had been met; the scenario had been considered
realistic and had taken into account the characteristics of
the different livestock production systems in the five
Nordic countries and contained good challenges for the
participants. Furthermore, a high level of commitment was
noted during both the preparation and the conduct of the
simulation exercise.
With regard to the elements of the exercise calling for
cross-border collaboration between the five countries, the
following observations and conclusions were made:
– bi-weekly telephone conferences between the CVOs
were useful for ensuring good information exchange. At an
early stage of an actual crisis these conferences should be
scheduled at fixed time-points;
– during epidemiological investigations all five countries
made use of the epidemiological questionnaires available
in the contingency plans. When required, the results from
the investigations were rapidly transmitted to
neighbouring countries by phone, fax and email;
Rev. sci. tech. Off. int. Epiz., 27 (3) 755